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Age at natural menopause and life expectancy with and without type 2 diabetes

Asllanaj, Eralda MD, MSc, DSc1,2; Bano, Arjola MD, MSc, DSc1,3; Glisic, Marija MD, MSc1; Jaspers, Loes MD, PhD1; Ikram, Mohammad Arfan MD, PhD1,4; Laven, Joop S.E. MD, PhD5; Vőlzke, Henry MD, PhD2,6,7; Muka, Taulant MD, PhD1; Franco, Oscar H. MD, PhD1,8

doi: 10.1097/GME.0000000000001246
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Objective: Effective interventions of future health care require a better understanding of the health risks associated with early onset of menopause and diabetes, but the necessary data are scarce. Little quantitative information is available about the combined association of early menopause and diabetes on life expectancy and the number of years lived with and without diabetes.

Methods: We included 3,650 postmenopausal women aged 45+ years from the Rotterdam Study, a prospective population-based cohort study. Age at menopause categories were defined as follows: early (≤44 y old), normal (45-54 y old), and late (≥55 y old). For life table calculations, we used prevalence, incidence rates, and hazard ratios for three transitions (free of diabetes to diabetes, free of diabetes to death, and diabetes to death) stratifying by age at menopause categories and adjusting for confounders.

Results: Compared with late menopause, the difference in life expectancy for women who experienced early menopause was −3.5 (95% CI, −6.6 to −0.8) years overall and −4.6 (95% CI, −8.9 to −0.9) years without diabetes. Compared with age at normal menopause, the difference in life expectancy for women who experienced early menopause was −3.1 (95% CI, −5.1 to −1.1) years overall and −3.3 (95% CI, −6.0 to −0.6) years without diabetes.

Conclusions: Women who experienced early menopause lived less long and spent fewer years without diabetes than women who experienced normal or late menopause.

1Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

2Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

3Department of Internal Medicine, Section Pharmacology Vascular and Metabolic Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands

4Department of Neurology, Erasmus University Medical Center, The Netherlands

5Department of Obstetrics and Gynecology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands

6German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany

7German Center for Diabetes Research, Partner Site Greifswald, Greifswald, Germany

8Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Address correspondence to: Eralda Asllanaj, MD, MSc, DSc, Department of Epidemiology, Erasmus University Medical Center, Dr. Molewaterplein 50, Office NA29-11, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail: e.asllanaj@erasmusmc.nl

Received 10 June, 2018

Revised 4 September, 2018

Accepted 4 September, 2018

Authors’ contribution: Study concept and design—TM and OHF; acquisition, collection, analysis, or interpretation of data—EA, AB, MG, LJ, MAF, JSEL, HV, TM, and OHF; drafting of the manuscript—EA and TM; critical revision of the manuscript for important intellectual content—AB, MG, LJ, MAF, JSEL, HV, TM, and OHF; statistical analyses: EA study supervision—TM, OHF. All authors approved the final version of the manuscript.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

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© 2019 by The North American Menopause Society.